OBJECTIVETo observe treatment efficacy of acupuncture at different distal acupoints for acute lumbar sprain after massage.

METHODSOne hundred and fifty patients with acute lumbar sprain were randomly divided into a Yaotongdian (Extra) group, a Houxi (SI 3) group, a Weizhong (BL 40) group, a Chengshan (BL 57) group and a Shuigou (GV 26) group, total 5 groups, 30 cases in each one. After the same massage treatment and based on groups divided, different distal acupoints above-mentioned were selected to be acupunctured. Visual analogue scale (VAS) scores, lumbar activity and treatment efficacy of patients in 5 groups were evaluated.

RESULTSWith acupuncture at distal acupoints after massage,VAS scores of patients in 5 groups were decreased compared with those after massage treatment (all P<0.05); lumbar activity was all obviously improved (all P<0.01); and cured and markedly effective rates were all increased in comparison with those after massage (all P<0.01). But among 5 groups the differences of VAS scores, lumbar activity and cured and markedly effective rates were not statistically significant(all P>0.05).

CONCLUSIONBased on massage treatment, acupuncture at distal acupoints could further improve the treatment efficacy for acute lumbar sprain, but there is no obvious effective difference among every distal acupoint. As long as choosing acupoints with lower pain threshold and stimulating enough, good efficacy could be acquired for acute lumbar sprain.

Acupuncture Points ; Acupuncture Therapy ; Acute Disease ; therapy ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Lumbosacral Region ; injuries ; Male ; Massage ; Middle Aged ; Sprains and Strains ; therapy ; Treatment Outcome ; Young Adult

Objective To investigate the successful rate and the therapeutic effect of loosening posterior tubercle of cervical transverse process with CT-guided insertion or blind insertion of small needle knife for cervical spondylotic radiculopathy. Methods Ninety patients with cervical spondylotic radiculopathy were divided into CT-guided insertion group and blind insertion group in the admission order using the random number table method, 45 cases in each group. CT-guided insertion group adopted the insertion of small needle knife following by the guide of CT, and the blind insertion group adopted the insertion of small needle knife following by cervical bony landmarks and muscles. After insertion, the position of the small needle knife in patients of the two groups was located by CT scan. If the needle knife did not arrive to the foci, it will be inserted again following by the guide of CT till successful insertion and location. The successful rate for the two times of insertion was calculated, and the pain scores were evaluated by visual analogue scale(VAS). Results(1) The successful rate for the first insertion of CT-guided insertion group was 73.3％, and that of the blind insertion group was 47.8％, the difference being significant(P < 0.01). The successful rate for the second insertion of CT-guided insertion group was 92.2％, and that of the blind insertion group was 80.0％, the difference being significant (P<0.01). (2) After treatment for one week, pain VAS scores of the two group were decreased (P < 0.01 compared with those before treatment) , and the decrease in the CT-guided insertion group was more obvious than the blind insertion group (P < 0.05). Conclusion CT-guided insertion makes the small needle knife therapy be more accurate and safer, ensures much better therapeutic effect, and brings less pain in the patients.

Objective To study the reliability and validity of the Chinese version of the dynamic occupational therapy cognitive assessment for children (DOTCA-Ch).Methods The English version of the DOTCA-Ch was translated into Chinese. One hundred and nine students from the city of Jiamusi were assessed with the Chinese Binet intelligence test and the DOTCA-Ch. Intra-class correlation coefficients (ICCs) were used in inter-rater and intra-rater reliability assessments. Cronbach's alpha coefficient was used to assess internal consistency. Factor analysis was used to assess construct validity. Pearson correlation coefficients were used in assessing criterion-related validity. Results The total ICC of the DOTCA-Ch was 0. 892. Cronbach's alpha coefficients for the subtests were orientation 0. 713 ; spatial perception 0. 793 ; praxis 0. 850 ; visuomotor construction 0. 844 and thinking operations 0. 630. The ICC for intra-rater reliability was 0. 991 and for inter-rater reliability it was 0. 989. Using the Binet intelligence test as a benchmark, the Pearson correlation coefficient between the IQ values and the total DOTCA-Ch scores was 0. 872 for 6 year-olds, but 0. 870 for 11 and 12 yearolds. Factor analysis revealed an acceptable set of 5 common factors. Their cumulative contribution was 67％.Conclusions The Chinese version of the DOTCA-Ch is reliable and valid. It can be used as an effective measuring tool to evaluate children's cognitive functioning.

AIM: To explore the treatment of subclinical hepatic encephalopathy(SHE) by traditional Chinese medicine. METHODS: Sixty patients with SHE were randomized into two groups: treatment group with 30 cases treated by Qingkai Granule and control group with another 30 cases treated by lactulose.They were all treated for two weeks.The evoked potentials(Eps) were measured,moreover,number connection test(NCT) and digit symbol test(DST) were conducted. RESULTS: In treatment group,the period for NCT was shorter and the DST also improved apparently;peak latency(PL) and interpeak latency(IPL) of SEP and AEPs were shorter to different degrees,with significant differences among groups. CONCLUSION: Qingkai Granule acts to effectively increase the learning,memory and space cognitive capacities in patients,and improves the nerve electrophysiology in patients.

Objective To investigate the effect of two different injection durations and four local pressing durations on the incidence of subcutaneous hemorrhage after low molecular weight heparin, and find a optimum injection duration and pressing time to reduce the incidence of subcutaneous hemorrhage associated with subcutaneous low molecular weight heparin. Methods 80 patients, who were deep venous thrombosis (DVT), pulmonary embolism (PE), and undergone inferior vena cava filter (IVCF) after the operation and received low molecular weight heparin (LWMH) for eight times were selected. The injection time and pressing duration after the injection were randomized into 30 s and 2 min, 30 s and 6 min, 30 s and 10 min, 30s and 14 min, 10s and 2 min, 10s and 6 min, 10 s and 10 min, 10 s and 14 min respectively. The incidence of subcutaneous hemorrhage were measured after 12 h. Single and multiple factor logistic regression analysis were used to analyze the data. Results The injection time and pressing duration after the injection were randomized into 30 s and 2 min, 30 s and 6 min, 30 s and 10 min, 30 s and 14 min, 10 s and 2 min, 10 s and 6 min, 10 s and 10 min, 10 s and 14 min respectively. The results of the incidence rate of subcutaneous hemorrhage were 46.25% (37/80), 22.50% (18/80), 23.75% (19/80), 25.00% (20/80), 71.25% (57/80), 43.75% (35/80), 50.00% (40/80), 50.00% (40/80) respectively. By the single factor test, the results showed that pressing duration and injection duration are associated with the incidence of subcutaneous hemorrhage after low molecular weight heparin. With regard to the incidence of subcutaneous hemorrhage, there was significantly difference between 2 min group and the other 3 groups (P<0.01), while other adjacent groups had no significant differences (P>0.05). By multiple factors logistic regression analysis, it was revealed that pressing duration and injection duration were significant factors (P<0.01), but the interaction term of pressing duration and injection duration had no significant. It was also revealed that the effect of injection duration was better than pressing duration (|b'(injection duration)|=|-1.8890|>|b'(pres ing duration)|=|-1.0729|). Compared with inject 10 s, there was a significantly lower incidence of bruising in inject 30 s. There was a significantly lower incidence of bruising in the longer pressing duration (b<0). By multiple factors logistic regression analysis, it was also revealed that pressing duration and injection duration were significant factors regardless of the interaction term of pressing duration and injection duration (P<0.01). The effect of injection duration was better than pressing duration (|b'(injection duration)|>|b'(pres ing duration)|). Compared with inject 10 s, there was a significantly lower incidence of bruising in inject 30 s (b<0). there was significantly difference between 2min group and the other 3 groups (P<0.01), while other adjacent groups had no significant differences. Compared with others, there was a significantly high incidence of bruising in pressing 2min and the pressing duration for at least 6 min. Conclusions It is suggested that inject 30 s with pressing for 6 min can effectively reduce the incidence of subcutaneous hemorrhage resulted from subcutaneous injection of LMWH.

A simple, fast and sensitive analytical method for the simultaneous separation and detection of 18alpha-glycyrrhizinic acid, 18beta-glycyrrhizinic acid, related substance A and related substance B by RP-HPLC and drug quality standard was established. The structures of principal component isomer and related substances of raw material drug of ammonium glycyrrhizinate have been confirmed. Reference European Pharmacopoeia EP7.0 version, British Pharmacopoeia 2012 version, National Drug Standards of China (WS 1-XG-2002), domestic and international interrelated literature were referred to select the composition of mobile phase. The experimental parameters including salt concentration, pH, addition quantities of organic solvent, column temperature and flow rate were optimized. Finally, the assay was conducted on a Durashell-C18 column (250 mm x 4.6 mm, 5 microm) with 0.01 mol x mL(-1) ammonium perchlorate (add ammonia to adjust the pH value to 8.2) -methanol (48 : 52) as mobile phase at the flow rate of 0.8 mL x min(-1), and the detection wavelength was set at 254 nm. The column temperature was 50 degrees C and the injection volume was 10 microL. The MS, NMR, UV and RP-HPLC were used to confirm the structures of principal component isomer and related substances of raw material drug of ammonium glycyrrhizinate. Under the optimized separation conditions, the calibration curves of 18 alpha-glycyrrhizinic acid, 18beta-glycyrrhizinic acid, related substance A and related substance B showed good linearity within the concentration of 0.50-100 microg x mL(-1) (r = 0.999 9). The detection limits for 18alpha-glycyrrhizinic acid, 18beta-glycyrrhizinic acid, related substance A and related substance B were 0.15, 0.10, 0.10, 0.15 microg x mL(-1) respectively. The method is sensitive, reproducible and the results are accurate and reliable. It can be used for chiral resolution of 18alpha-glycyrrhizinic acid, 18Pbeta-glycyrrhizinic acid, and detection content of principal component and related substances of raw material drug of ammonium glycyrrhizinate. It is concluded that the separation of principal component isomer of raw material drug of ammonium glycyrrhizinate and the validity of the substance's structure assignments of retention time being 1.2 in the European pharmacopoeia EP7.0 version, British pharmacopoeia 2012 version remains open to question. It may be of practical value for the quality control of raw material drug, preparation, and Chinese herbal medicine of ammonium glycyrrhizinate.

OBJECTIVEThe aim of this study was to survey the influence of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) repression to receptor activator of nuclear factor-kappaB ligand (RANKL) expression of human periodontal ligament fibroblasts (HPDLFs) under the stimulation of lipopolysaccharide (LPS).

METHODSThe level of RANKL in HPDLFs stimulated by 100 ng x mL(-1), 1 microg x mL(-1) and 10 microg x mL(-1) Escherichia coli (E. coli) LPS after 6, 12, 24 and 48 h was detected by enzyme linked immunosorbent assay (ELISA). The level of RANKL in HPDLFs stimulated by 1 microg x mL(-1) E. coli LPS after pretreatment with different titre anti-TLR2+anti-TLR4, anti-TLR2 and anti-TLR4 antibody were observed respectively.

RESULTSRANKL was detected at 6 h after stimulation with LPS, and the levels of these cytokine were highest at 24 h, and then gradually decreased. The regularity of each LPS concentration was approximately similar. After pretreatment with anti-TLR2+anti-TLR4, anti-TLR2 and anti-TLR4 antibody, the level of RANKL was significantly decreased under the stimulation of 1 microg x mL(-1) LPS (P<0.05). In the three groups, the expression of RANKL was significantly different (P<0.05). The level of RANKL in anti-TLR2+anti-TLR4 antibody pretreatment group was the lowest, the level in anti-TLR4 antibody pretreatment group was higher, and the level in anti-TLR2 antibody pretreatment group was the highest.

CONCLUSIONTLR2 and TLR4 participate in the process of RANKL expres-in HPDLFs induced by LPS. Anti-TLR4 antibody has better inhibition effect to RANKL expression of HPDLFs stimulated by LPS than anti-TLR2.

Escherichia coli ; Fibroblasts ; Humans ; Lipopolysaccharides ; Periodontal Ligament ; RANK Ligand ; Toll-Like Receptor 2 ; Toll-Like Receptor 4

Nonalcoholic fatty liver disease has become the most important chronic liver disease in China and the leading cause of abnormal liver biochemical parameters in physical examination. Mitophagy can degrade the mitochondria with impaired function and misfolded protein in the liver to regulate cell death and help to maintain stable lipid metabolism in the liver. The binding of adiponectin secreted by adipose tissue to adiponectin receptor 2 can increase the secretion of autophagy agonists in Kupffer cells, induce hepatocyte mitophagy, promote lipid metabolism, and thus reduce liver inflammation, which provides new thoughts for the research and development of drugs with a marked clinical effect and a clear mechanism of action in the treatment of nonalcoholic fatty liver disease.

OBJECTIVETo investigate the phenotype-genotype association of isodicentromere Y chromosome by analysis of two female patients carrying the chromosome with sexual development disorders.

METHODSThe karyotypes of the two patients were determined by application of conventional G banding of peripheral blood samples and fluorescence in situ hybridization (FISH). PCR was applied to detect the presence of SRY gene.

RESULTSConventional karyotype analysis showed case 1 to be a mosaic: mos.45,X[38]/46,X,+mar[151]/47,XY,+mar[5]/47,X,+mar × 2[2]/46,XY[4], FISH showed that 12 different cell lines were presented in the karyotype of case 1 and partial cell lines with SRY gene, the marker is an isodicentromere Y chromosome [idic(Y)(p)]. No mutation was found in the SRY gene. The karyotype of case 2 was mos.45,X[25]/46,X,+mar[35]. FISH showed the marker to be an idic(Y)(p) without the SRY gene.

CONCLUSIONThe karyotype of patients carrying idic(Y)(p) seems unstable, and female patients have the characteristics of short stature and secondary sexual hypoplasia. Karyotype analysis combined with FISH analysis can accurately determine the breakpoint of idic(Y) and identify the types of complex mosaic, which may facilitate genetic counseling and prognosis.

Adolescent ; Child ; Chromosomes, Human, Y ; Disorders of Sex Development ; genetics ; Female ; Humans ; Karyotype ; Sex Chromosome Aberrations ; Sex-Determining Region Y Protein ; genetics